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Archived: Ashton House Nursing Home

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Inspection report

Date of Inspection: 13 March 2013
Date of Publication: 3 April 2013
Inspection Report published 3 April 2013 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 13 March 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Our judgement

People experienced care, treatment and support that met their needs and protected their rights.

Reasons for our judgement

People’s needs were assessed, and their care and treatment was planned and delivered in line with their individual care plan.

We looked at six care plans, three in the main house, and three on Hazelwood Unit. We found that care plans covered all aspects of daily living, such as people’s personal hygiene needs, their ability to communicate, their mobility, nutrition, medication, and mental health.

Care plans were accompanied by assessments for specific aspects of care, including people’s nutrition, falls risks, their dependency, risk of developing pressure ulcers, moving and handling risks, and risks associated with equipment. This included the use of bed rails and lap belts in wheelchairs. We saw that most of these had been put in place and checked and signed with the person concerned or their representative. We saw that one person had a risk assessment to use a lap belt for safety when using a wheelchair but we did not see a consent form for this.

We saw that daily reports included basic details of people’s mood and their eating and drinking, but did not always include reference to their personal hygiene care, or the activities carried out during the day. We found that separate activities records were maintained by the activities co-ordinators and these were suitably detailed records. We saw that some of the records for personal care did not clearly show if a person had had a bath or shower, shave, wash, hair wash etc. Separate personal care charts were available, but had not all been completed every day.

We saw that additional folders were maintained with charts for documenting hourly checks, people’s food and fluid intake, staff accountability checks, and completed medication administration records. We found these folders to be untidy, and this was unhelpful for staff or visiting health professionals who may need to access information at short notice. We also noted that some fluid charts had not been added up, which meant that staff did not understand the significance of these, in that visiting doctors might wish to see if people had made progress or developed changes with their fluid intake or output.

We talked with one of the managers and two care staff, and they demonstrated an understanding and application of the Mental Capacity Act 2005, and the importance of allowing people to make their own decisions where they were able to do so. This included decisions such as which activities they would like to take part in; which clothes to wear, and which food they liked to eat.

We observed that people were visibly clean and well groomed, and staff were attentive to their needs. However, the provider may find it useful to note that the care planning did not always accurately reflect the care being given as some of it lacked attention to detail. This had already been noted by one of the care managers who had been auditing care plans.

We found that the home provided a wide range of activities, and included weekly entertainment as people really enjoyed music, singing, dancing and shows. The activities co-ordinators carried out some group activities such as quizzes and reminiscence, and also gave people individual attention. They arranged for visiting “pat dogs” which people said they enjoyed; and bus trips every two weeks. These were to local parks and places of interest.

People were supported in meeting their spiritual needs through the visits of local church members and clergy. A church service and communion was held in the home on a regular basis, and people could attend this if they wished to do so. They were also able to have individual visits with prayer or communion in their own rooms.

People living in the home and relatives that we spoke to praised the staff and the care given to people. One relative said “They have transformed my relative’s life since she has been here. She is so much better. Staff communication is excellent, they always contact me if there are any concerns.”